The authors present a retrospective case review study of a cohort of patients with Lester Jones’ tubes first placed between 1969 and 1989, and who were reviewed within the last 15 years. Twenty-nine patients (33 eyes) were included in the study. The average follow-up was 29.5 years (median 28.8 years, range 17-45.7 years). The aetiology for canalicular block was known in 97% (32/33) cases, the commonest being post-herpetic obstruction (24%), congenital causes (18%), post-radiation (12%), and failed multiple lacrimal surgery. In 32 eyes where survival of the first placed tube was known, it varied widely from 18 days to 44.4 years, with an average survival of 13.6 years (median 6.9 years) – and retention of the initially placed device in this cohort was 50% at five years, 30% at 20 years, and 25% beyond 30 years. Eight eyes (24%) still had the original device in place with 6/8 (75%) placed in the 1970s and 2/8 (25%) in the 1980s. Survival of the initial tube was notably longer for congenital atresia (mean 16.1 years) and post-herpetic block (mean 16.9 years), as compared to that in patients with facial palsy (<3 months) or after trauma (11 months). At last follow-up, 11/33 (33%) of eyes had lost their tubes, with nine of them having minimal or no symptoms. 

Can Lester Jones tubes be tolerated for decades?
Scawn RL, Verity DH, Rose GE.
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Sofia Rokerya

MBBS MRCOphth FRCSI, King's College University Hospital, UK.

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